DC Child Accident & Safety Blog

Pop quiz: Which of the following promote tooth decay?

(A). sugar;
(B). genetics;
(C). low immunity;
(D). watching "American Idol."

The correct answer, of course, is "all of the above" ... with a qualifier for (D). (You have to be snacking on Raisinettes or another sticky fruit while watching the show.)

Although sugar remains the primary suspect in the creation of cavities, people can be genetically disposed toward tooth decay, and low immune function can contribute, as can dietary habits generally considered healthful--sticky fruits such as raisins, although preferable to sucking on a Popsicle, also leave teeth vulnerable to the ravages of sugar residue.

So what can a concerned parent do?

It's hard enough for parents to control so many factors conspiring to turn their kids' mouths into a gaping maw of dental disaster, but now there's something else to consider. According to the Los Angeles Times, several studies have shown that cavity-causing bacteria can be passed from primary caregivers to wee ones.

Children are most susceptible as infants and toddlers, when their immune systems are works-in-progress. But any age before children have the motor skills necessary to brush well by themselves requires parental invervention for maximum protection.

If you want to hold the line on sharing the bacterial love that can compromise your child's oral health not only as a youngster but after the arrival of permanent teeth and into adulthood, first take care of yourself. Expectant mothers should address any dental decay or gum problems before Junior arrives to reduce the likelihood of transmitting disease. And the use of an antibacterial mouthwash during the lower-immune period of infancy and toddlerdom might be wise.

In addition, the dentist should become a close, personal friend of your child probably earlier than you expect. Measures you should take include:

• schedule the first visit to a pediatric dentist at the time the first tooth appears or by the first birthday;


• limit the contents of bottles and sippy cups to water except at mealtime;


• limit snacking to a short interval--bacteria like any kind of sugar, whether from fruit, milk, honey or the refined white sugar in candy;


• assist your child with tooth-brushing until he or she is old enough to tie shoes or write cursive--generally 7 to 9 years old.

A review of studies about the contents of energy beverages has raised serious questions about their efficacy and safety. The review, published in the November issue of the Mayo Clinic Proceedings, noted that the drinks contain high levels of caffeine and could pose dangerous, even life-threatening effects on blood pressure, heart rate and brain function to some susceptible individuals.

The study found four documented cases of caffeine-associated death and five separate cases of seizures associated with consumption of energy/power drinks. Other reports included: (1) an otherwise healthy 28-year-old man who suffered a cardiac arrest after a day of motocross racing; (2) a healthy 18-year-old man who died playing basketball after drinking two cans of Red Bull; and (3) four cases of mania experienced by individuals known to have bipolar disorder.

Noting that teens and young adults are consuming energy drinks “at an alarming rate,” the study authors said it was important to determine whether long-term use of these beverages “will translate into deleterious effects later,” such as liver and cardiovascular disease, insulin resistance and diabetes.

Currently, the drinks are labeled as “dietary supplements,” which exempts them from regulations governing sodas and juices and allows manufacturers to make “ “structure and function” claims, like “enhances athletic performance” and “increases caloric burn and mental sharpness.”

The American Beverage Association says most mainstream energy drink brands voluntarily put statements on their containers, including advisories about use by people sensitive to caffeine, and many also list the amount of caffeine on their product labels or have provided caffeine content information through their Web sites and consumer hot lines.

But the study authors worry that some athletes who exercise intensively are substituting energy drinks for sport drinks (which only contain sugar and electrolytes). They say the high doses of sugar in energy drinks can impair absorption of fluids and result in dehydration, noting that a 16-ounce can of an energy drink may contain 13 teaspoons of sugar and the amount of caffeine found in four or more colas.

Source: The New York Times

You can view an abstract of the study published in the Mayo Clinic Proceedings here.

Two officials from the Governors Highway Safety Association (GHSA) blamed First Lady Michelle Obama’s Let’s Move anti-obesity program for a small increase in pedestrian fatalities, then quickly backtracked after almost universal negative reaction to their remarks.

GHSA executive director Barbara Harsha told the Washington Examiner that “there is an emphasis these days to getting fit, and I think people doing that are more exposed to risk [of getting hit by a vehicle].” Another GHSA spokesman, Jonathan Adkins, told a local radio station that the First Lady is “trying to get us to walk to work and exercise a little bit more. While that's good, it also increases our exposure to risk.”

In 2010, 1,891 road deaths were recorded in the U.S., an increase of seven, or 0.2%, bucking a longterm downward trend. Harsha noted that “many factors” could be responsible for the small uptick, including increased use of iPhones, mp3 players and other devices that make pedestrians less aware of oncoming traffic.

The GHSA officials’ remarks were universally criticized, prompting quick retractions. Harsha later claimed she was misquoted and that the GHSA "in no way opposes Ms. Obama's program." Adkins now says he “did not blame Mrs. Obama for the small uptick in pedestrian deaths but simply noted that programs such as Mrs. Obama's may be increasing the number and frequency of pedestrians and thus exposing them to more risk.”

Sources: Washington Examiner and TheAtlanticWire

In a recent news release, FDA warns parents and caregivers of the risk of overdosing infants with liquid vitamin D. The liquid supplement is administered with droppers that are sold with the supplement itself. However, some of the droppers hold more vitamin D than is appropriate for babies.

Vitamin D supplements are recommended for some children to promote growth of healthy and strong bones. However, if fed with excessive amount of vitamin D, infants experience a myriad of symptoms ranging from nausea to muscle weakness, and sometimes even kidney damage.

Here are the FDA’s recommendations for parents whose children receive vitamin D supplements:

* Ensure that your infant does not receive more than 400 international units (IUs) of vitamin D a day, which is the daily dose of vitamin D supplement that the American Academy of Pediatrics recommends for breast-fed and partially breast-fed infants.
* Keep the vitamin D supplement product with its original package so that you and other caregivers can follow the instructions. Follow these instructions carefully so that you use the dropper correctly and give the right dose.
* Use only the dropper that comes with the product; it is manufactured specifically for that product. Do not use a dropper from another product.
* Ensure the dropper is marked so that the units of measure are clear and easy to understand. Also make sure that the units of measure correspond to those mentioned in the instructions.
* If you cannot clearly determine the dose of vitamin D delivered by the dropper, talk to a health care professional before giving the supplement to the infant.
* If your infant is being fully or partially fed with infant formula, check with your pediatrician or other health care professional before giving the child vitamin D supplements.

A study that tracked millions of schoolchildren shows that children are more likely to be obese when their schools are close to a fast food joint, reports Roni Rabin of New York Times. The study is headed by economists at the University of California and Columbia University, and spanned almost a decade.

Enrico Moretti, one of the study’s authors, indicated that the study does not explain why students closer to a fast food restaurant are more likely to become obese, but affirmed the “credible and unbiased” causal effect it establishes between obesity and fast food.

Providing one more piece of evidence that fast food contributes to child obesity, this study has implications for public policy, said Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale University. Neighborhoods and school district may choose to “zone out” fast food restaurants to protect their children’s health.

Caffeine is technically a drug, although it's hard to think of it like that.

But some experts are saying that, because caffeinated energy drinks promise some of the same effects as prescription drugs, they should be labeled so kids know that anything that produces those effects has to be treated with caution:

Because energy drinks are touted as performance enhancers and stimulants, Dr. Roland R. Griffiths explained in an interview with Reuters Health, kids who use them for these reasons will likely be more open to trying prescription drugs that promise the same effects.

"It seems like it's a pretty easy threshold to step over, but as a society we want to make this a bright line," Griffiths said in an interview.

In their report on the marketing, regulation and health effects of caffeinated energy drinks published this month in the journal Drug and Alcohol Dependence, Griffiths and his colleagues at The Johns Hopkins University School of Medicine call for regulations requiring energy drink makers to list the caffeine content of their products on their labels, and warn of the potential for caffeine intoxication.

The whole article merits reading as it contains a lot of little-known information about energy drinks and how they are manufactured and what they contain.

Recently, there was an outcry about new recommendations from the American Academy of Pediatrics that suggest giving kids as young as 8 years old cholesterol-reducing statin drugs.

Tara Parker-Pope discusses the controversy in a recent column. Those who object to the new recommendations worry about the drugs' long-term consequences, the AAP's financial relationships with drug companies and the possibility that the new guidelines will lead to overuse of the drugs. The defenders argue that the guidelines specify that only a very small group of children--those with strong genetic and lifestyle risk factors--would even be considered for statin therapy. Parker-Pope's whole article is worth reading, as it discusses both the financial and the medical aspects to this debate.

One problem here is widespread throughout medicine: what some have called "indication sprawl." Once a drug or treatment is recommended for one narrow category of patients, it tends to get indicated for more and more categories with less and less testing and justification for the new categories. But more profit for the drug makers.

This blog has previously discussed the dangers of bisphenol A (called BPA), a common ingredient in the plastics used to make baby bottles, for fetuses, babies and small children. The intended effect of BPA is to make the bottle shatterproof, which it does, but now evidence of its side-effects are coming to light.

Now four Ohio parents are filing a class-action suit against five baby-bottle manufacturers, alleging that the manufacturers knew about the dangers of BPA but continued to use it in their bottles anyway.

From the article:

The parents, all from Franklin County, sued Avent America of Bensenville, Ill.; Handi-Craft Co. of St. Louis, also known as Dr. Brown's; Evenflo Co. of Vandalia; Gerber Products Co. of Parsippany, N.J.; and Playtex Products of Westport, Conn., on behalf of themselves and others who bought the products.